Dr. Laorwong, Absolute Hair Clinic - Bangkok | 4,000 grafts | 2024-06-16 |

[roheezy]

I'm just starting this thread to document my journey with Dr. Laorwong. I've been able to use this forum to assist me in my decision making process, as well as help answer my questions. My surgery is scheduled for June 16, 2024 and I've already attended my Pre-Operation appointment. I've been

Background

• Age: 32
• Meds:
  • I took finasteride daily for a few months back in 2017 but I found it was messing with my body. Didn't feel right and my libido was down so didn't want to continue with it. 
  • I used to take biotin but I only really saw results on my fingernail growth!
  • I have psoriasis but I take Skyrizi (biologic injectable every 3 months) and Omega-3 (2,000mg/daily), Curcumin and Berberine. Combined, these all manage my psoriasis which generally starts on my body but has progressed in one instance to facial and scalp psoriasis. For a year and a half it's been totally under control. My dermatologist had indicated I needed to take Skyrizi for at least a year before considering doing a hair transplant so that my scalp could be ready for the barrage and hopefully not get inflamed. When I saw her before making my appointment for the surgery she confirmed I was in good shape.
  • The doctor indicated to stop taking fish oils (aka Omega-3) so I have stopped for now but hoping to resume post-surgery
  • I used to have dandruff but ever since I started on the supplements, it's gone away. It used to snow from my head 365 days/year too!
• Balding history: first noticed thinning around age 20 but it got much worse around 25, with loss on my crown as well.
• Family history: My dad has the same baldness pattern as me but I feel like we're almost similar except his hair is mostly white now (he's 70). My brother has similar hair loss to my mother which is more thinning in general. My grandpa (mom's side) was eventually bald except for the sides till about 80, and then fully bald but he reached the ripe old age of 103.
• Price: 80THB / graft, for a total of 320,000THB. 20kTHB deposit over Wise, then the remainder with Visa or Mastercard after surgery for no additional fee. Included a PRP injection and light therapy. He also offered hyperbaric oxygen therapy (1 treatment - 4,000 TBH or 3 treatments 10,000 THB)
  • I haven't decided whether or not to do the hyperbaric therapy so if anyone has any thoughts let me know!
• Grafts: Estimated to be 4,000 total so will post the end results when I get it.

Consultation and Pre-Op

I communicated with the clinic over WhatsApp and was talking direclty to the doctor. The consultation process was a bit basic compared to what everyone else was offering but in reading the reviews here I got that vibe and understood he was qualified. I sent him some pictures and he marked up the areas I needed surgery on. He estimated 4k for the front and 2k for the crown in two separate surgeries. He confirmed this when I met him yesterday. 

At the pre-op appointment, I filled out an intake form and the receptionist was very friendly. When I met with him, he wasn't overly friendly but seemed to know what he was doing and I'm trying to trust the process! He drew the hairline which was conservative but that's where I want to end up given my situation. We agreed to focus on the front but he was going to try and fill in a bit on the crown as that's not as important to me on the first go around. If I want to come back, I can do that in a year.  He measured my donor area and confirmed that I was all good for surgery.They took pre-op photos, which hopefully I can send over but I'll attach the consultation photos for general reference. I'm staying in Bangkok for about five months so my big thing was aftercare and monitoring my situation especially given my psoriasis. He indicated that on top of the 5 days, I could come in afterwards for other check-in appointments which made me feel comfortable.

They gave me antiseptic shampoo that I used that night and in the morning before surgery.

Excuse the horrible quality (and background) of the photos. I was traveling around Southeast Asia at the time so only was in basic accommodations haha.

[raiynx]

Excited for your journey @roheezy, please do keep us updated often. Curious for post-OP photos when you do it soon. Especially since I am scheduled for Laorwong too. Definitely any details you think of during the journey would be helpful!

[Al - Moderator]

Thank you for posting. Please keep us updated over the coming months. 

[A_4_Archan]

Best of luck...you will be under safe hands and yeh say my hi to him. 

[roheezy]

2 hours ago, Al - Moderator said:

Thank you for posting. Please keep us updated over the coming months. 

Yes will definitely keep everyone posted once I have the surgery and get some of the material back from him. I'm a bit nervous about the hair line and the post-op maintenance but being beside the clinic for the next few weeks and being able to pop-in for quick check-ins in the late afternoon will probably put my mind at ease. Does anyone have any thoughts on the extra oxygen treatment as noted earlier?

[Rawkerboi]

I inquired with my friend who underwent an HT with Dr. Laworwong about this. He stated, Hyperbaric oxygen therapy helps to minimize post surgical follicle shedding and leads to less folliculitis and itching.  This treatment must be taken within a time frame of less than 72 hours.

13 minutes ago, roheezy said:

Yes will definitely keep everyone posted once I have the surgery and get some of the material back from him. I'm a bit nervous about the hair line and the post-op maintenance but being beside the clinic for the next few weeks and being able to pop-in for quick check-ins in the late afternoon will probably put my mind at ease. Does anyone have any thoughts on the extra oxygen treatment as noted earlier?

 

[Melvin- Admin]

19 minutes ago, roheezy said:

Yes will definitely keep everyone posted once I have the surgery and get some of the material back from him. I'm a bit nervous about the hair line and the post-op maintenance but being beside the clinic for the next few weeks and being able to pop-in for quick check-ins in the late afternoon will probably put my mind at ease. Does anyone have any thoughts on the extra oxygen treatment as noted earlier?

It looks like it helps with healing and possibly minimizing shock loss and shedding.

https://pubmed.ncbi.nlm.nih.gov/32770782/

[roheezy]

2 hours ago, Rawkerboi said:

I inquired with my friend who underwent an HT with Dr. Laworwong about this. He stated, Hyperbaric oxygen therapy helps to minimize post surgical follicle shedding and leads to less folliculitis and itching.  This treatment must be taken within a time frame of less than 72 hours.

 

Did he actually take this treatment as well? I'm probably leaning towards it just to be safe. @Melvin- Admin - that's generally what I've been reading too that it provides some benefit. I'm already undergoing light therapy and PRP. Just wondering if it's overkill but sounds like it can't hurt especially with my psoriasis.

[Rawkerboi]

8 hours ago, roheezy said:

Did he actually take this treatment as well? I'm probably leaning towards it just to be safe. @Melvin- Admin - that's generally what I've been reading too that it provides some benefit. I'm already undergoing light therapy and PRP. Just wondering if it's overkill but sounds like it can't hurt especially with my psoriasis.

He did take the treatment, it's quite safe. You can discuss with Dr. Laorwong if you have any concerns with respect to your Psoriasis

[ichigo]

All the best with your surgery today! I am booked in with Dr Laorwong in December and impatiently counting down the days..

[roheezy]

Hey everyone! I thought I'd give a little bit of an update since I've now completed the surgery as well as one day of post-op care. I have gone ahead with 5 days of post-op care including Light Therapy and the oxygenation tank and will go in at the two week, four week and maybe 3 month stage. I don't have the day of photos but I'll share those when I get them.

Day of Surgery

I arrived at the clinic at 8:30am. I'm literally living across the street at an Airbnb so it was a very quick commute. I was taken fairly quickly to do the HIV check to ensure I could do the PRP treatment during surgery and they took my order for lunch. Immediately afterwards I was taken up a few floors to change into surgery clothes (almost PJs). I had to wait about 15min for the doctor to arrive to draw the hairline and the donor area. I had some few corrections as I thought one side came up quicker than the other. I honestly didn't think it was fine but he assured it me was symetical so I went with his judgement. I had already gotten a buzzcut to mentally prep myself for what I would look like going forward for a few months so wasn't a big surprise to be essentially bald. They took some pre-op photos, gave me a drug cocktail (sleeping pill and some others that they did explain but I forget) and then I was off to the surgery room.

I was immediately placed face down for the donor portion of the surgery. As others indicated, they put on the leg massagers which felt nice but wish they had it on the entire time. One critique is there was very little communication throughout the surgery with me. I wish there more updates about what was happening, how much time, etc...

When everything got going, they did tell me the anesthesia was coming. They used what I can only describe as a massager at the same time and probably made 5-6 injections across my lower neck area. The nurses then started doing something - it did feel like they were doing the extractions but I had no idea. They only talked in Thai and when I asked when I would fall asleep (aka sleeping pills) would kick in they essentially ignored me. After about 15min the covered me up and then the doctor entered. Felt more relieved as one of the reasons I chose the clinic is I knew he was doing the surgery. After what felt like another 15-20min, I finally fell asleep only to awake with about 30min left in the extraction part and definitely some saliva on my phone haha (they put my phone below the head opening. Thankfully throughout the process, the numbness was effective except for a small area in my lower left part of the head but still didn't hurt that much.

Afterwards, it was time for a really quick lunch (15min) as I think we we were going a bit late as it was around 1:30pm at that time. I took another sleeping pill as I was fully awake and then back to the surgery chair for the implantation part.

More anesthesia was applied to the top part of my head and the process started again. Prior to doing this, they started the PRP process, which they warned me about. It was a weird feeling for sure but felt like it lasted about 10min. After that the implantation occurred. I felt what was going on but it didn't bother me too much. In about 30min I was knocked out again, and same thing, awoke with about 30min left to go. Afterwards I was back to the waiting room where they had a pastry and another pill. Again they told me but I can't recall what it was. Probably an antibiotic or something. They also gave me a pack pills and they had clear instructions on how much and when to take them. They bandaged me up and then I went to take care of the bill. Ended up coming out to 333k with everything. Taking into account everything, I did not leave the clinic until 8:30pm so 12hr surgery!

All in all, I ended up getting 4,166 grafts but the good news is they managed to fill in the crown as well as the frontal area so that was great news from my front. I got the conservative hairline and can hopefully avoid a second surgery for the crown area.

I am nervous for the next few days as this is when swelling can start and maybe my psoriasis can kick in but so far it seems clear and I can start taking my Omega-3 which helps immensely with managing so I am thinking positive thoughts.

My working hours are 7pm to 6am so when I arrived at home, I was not even close to tired but I forced myself to sleep after getting some food and passed out at around 1am. I didn't get a neck pillow so I layered two pillows on an angle and rolled up a towel for neck support and passed out on the couch which helped.

Day 1 Post-Op

My next appointment was 3pm and consisted of the cleaning, shampoo, checking the grafts and donor area and more photos. After that was complete, I did the light therapy followed by over an hour of the oxygen capsule. The doctor came in afterwards to check in and was happy with the results. He recommended finasteride given my hair loss appears to be continuing so I'll get back on a small dosage (0.5mg) and see if I can potentially switch to a minoxidil shampoo or something later. Not sure if anyone has seen anything they recommend.

Afterwards, they bandaged me up again and gave me a neck pillow as well. I'll be back tomorrow at the 3pm mark again to rinse and repeat.

Photos of the paperwork and the Day-1 post are below. If I get more, I'll upload them.  Feel free to share your thoughts good and bad!

 

[GibGob]

How does Dr. Laorwong measure donor density? Does he just comb through or rather use microscope?

[davidrotz]

Good luck!

[roheezy]

On 6/22/2024 at 7:10 PM, GibGob said:

How does Dr. Laorwong measure donor density? Does he just comb through or rather use microscope?

He didn't use a microscope while he was doing the pre-op. He just seemed to comb through.

[roheezy]

I'm currently sitting at the 9 day post-op mark. Everything appears to be healing up nicely but I'm still getting tingling and prickly feelings on my scalp. I've got a check-up appointment with the doctors office in a couple of days and will hopefully be able to take some additional pictures to share with everyone.

I've been using the baby shampoo they've supplied me and washing that daily and have just started using aloe vera and venturing outside. Starting to get my life back to normal minus the exercise and exposure to sun.

I'm hoping to add anything to my routine (already taking 2.5mg of finasteride/daily) to help with the hair follicle growth (i.e. planning for rosemary oil mixing with shampoo) so any thoughts would be great too (understanding no one here is a doctor!)

[CautiousResearcher]

On 6/25/2024 at 8:26 AM, roheezy said:

He didn't use a microscope while he was doing the pre-op. He just seemed to comb through.

Did he provide you with any quantitative info about your donor density?

[roheezy]

10 hours ago, CautiousResearcher said:

Did he provide you with any quantitative info about your donor density?

Not really - he mentioned I have about 6,000 grafts available in my donor area and post-surgery, more or less confirmed the same that I had 2,000 - 2,500.

[CautiousResearcher]

27 minutes ago, roheezy said:

Not really - he mentioned I have about 6,000 grafts available in my donor area and post-surgery, more or less confirmed the same that I had 2,000 - 2,500.

Thanks!